Modeling, Control, and Clinical Validation of an Upper-Limb Medical Education Task Trainer for Elbow Spasticity and Rigidity Assessment

The goal of this study was to validate a series elastic actuator (SEA)-based robotic arm that can mimic three abnormal muscle behaviors, namely lead-pipe rigidity, cogwheel rigidity, and spasticity for medical education training purposes. Key characteristics of each muscle behavior were first modele...

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Main Authors: Yinan Pei, Mahshid Mansouri, Christopher M. Zallek, Elizabeth T. Hsiao-Wecksler
Format: Article
Language:English
Published: IEEE 2023-01-01
Series:IEEE Transactions on Neural Systems and Rehabilitation Engineering
Subjects:
Online Access:https://ieeexplore.ieee.org/document/10216320/
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author Yinan Pei
Mahshid Mansouri
Christopher M. Zallek
Elizabeth T. Hsiao-Wecksler
author_facet Yinan Pei
Mahshid Mansouri
Christopher M. Zallek
Elizabeth T. Hsiao-Wecksler
author_sort Yinan Pei
collection DOAJ
description The goal of this study was to validate a series elastic actuator (SEA)-based robotic arm that can mimic three abnormal muscle behaviors, namely lead-pipe rigidity, cogwheel rigidity, and spasticity for medical education training purposes. Key characteristics of each muscle behavior were first modeled mathematically based on clinically-observed data across severity levels. A controller that incorporated feedback, feedforward, and disturbance observer schemes was implemented to deliver haptic target muscle resistive torques to the trainee during passive stretch assessments of the robotic arm. A series of benchtop tests across all behaviors and severity levels were conducted to validate the torque estimation accuracy of the custom SEA (RMSE: ~ 0.16 Nm) and the torque tracking performance of the controller (torque error percentage: < 2.8 %). A clinical validation study was performed with seven experienced clinicians to collect feedback on the task trainer’s simulation realism via a Classification Test and a Disclosed Test. In the Classification Test, subjects were able to classify different muscle behaviors with a mean accuracy > 87 % and could further distinguish severity level within each behavior satisfactorily. In the Disclosed Test, subjects generally agreed with the simulation realism and provided suggestions on haptic behaviors for future iterations. Overall, subjects scored 4.9 out of 5 for the potential usefulness of this device as a medical education tool for students to learn spasticity and rigidity assessment.
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spelling doaj.art-63564793b01b4c3a8775faf168cd40142023-08-21T23:00:13ZengIEEEIEEE Transactions on Neural Systems and Rehabilitation Engineering1558-02102023-01-01313320333010.1109/TNSRE.2023.330495110216320Modeling, Control, and Clinical Validation of an Upper-Limb Medical Education Task Trainer for Elbow Spasticity and Rigidity AssessmentYinan Pei0https://orcid.org/0000-0001-8357-3063Mahshid Mansouri1https://orcid.org/0000-0001-6336-9970Christopher M. Zallek2https://orcid.org/0000-0002-5959-3192Elizabeth T. Hsiao-Wecksler3https://orcid.org/0000-0002-9373-3611Department of Mechanical Science and Engineering, University of Illinois at Urbana-Champaign, Urbana, IL, USADepartment of Mechanical Science and Engineering, University of Illinois at Urbana-Champaign, Urbana, IL, USANeurology Department, OSF HealthCare, Peoria, IL, USADepartment of Mechanical Science and Engineering, University of Illinois at Urbana-Champaign, Urbana, IL, USAThe goal of this study was to validate a series elastic actuator (SEA)-based robotic arm that can mimic three abnormal muscle behaviors, namely lead-pipe rigidity, cogwheel rigidity, and spasticity for medical education training purposes. Key characteristics of each muscle behavior were first modeled mathematically based on clinically-observed data across severity levels. A controller that incorporated feedback, feedforward, and disturbance observer schemes was implemented to deliver haptic target muscle resistive torques to the trainee during passive stretch assessments of the robotic arm. A series of benchtop tests across all behaviors and severity levels were conducted to validate the torque estimation accuracy of the custom SEA (RMSE: ~ 0.16 Nm) and the torque tracking performance of the controller (torque error percentage: < 2.8 %). A clinical validation study was performed with seven experienced clinicians to collect feedback on the task trainer’s simulation realism via a Classification Test and a Disclosed Test. In the Classification Test, subjects were able to classify different muscle behaviors with a mean accuracy > 87 % and could further distinguish severity level within each behavior satisfactorily. In the Disclosed Test, subjects generally agreed with the simulation realism and provided suggestions on haptic behaviors for future iterations. Overall, subjects scored 4.9 out of 5 for the potential usefulness of this device as a medical education tool for students to learn spasticity and rigidity assessment.https://ieeexplore.ieee.org/document/10216320/Medical education trainingsimulationneurological examinationspasticityrigiditymuscle tone
spellingShingle Yinan Pei
Mahshid Mansouri
Christopher M. Zallek
Elizabeth T. Hsiao-Wecksler
Modeling, Control, and Clinical Validation of an Upper-Limb Medical Education Task Trainer for Elbow Spasticity and Rigidity Assessment
IEEE Transactions on Neural Systems and Rehabilitation Engineering
Medical education training
simulation
neurological examination
spasticity
rigidity
muscle tone
title Modeling, Control, and Clinical Validation of an Upper-Limb Medical Education Task Trainer for Elbow Spasticity and Rigidity Assessment
title_full Modeling, Control, and Clinical Validation of an Upper-Limb Medical Education Task Trainer for Elbow Spasticity and Rigidity Assessment
title_fullStr Modeling, Control, and Clinical Validation of an Upper-Limb Medical Education Task Trainer for Elbow Spasticity and Rigidity Assessment
title_full_unstemmed Modeling, Control, and Clinical Validation of an Upper-Limb Medical Education Task Trainer for Elbow Spasticity and Rigidity Assessment
title_short Modeling, Control, and Clinical Validation of an Upper-Limb Medical Education Task Trainer for Elbow Spasticity and Rigidity Assessment
title_sort modeling control and clinical validation of an upper limb medical education task trainer for elbow spasticity and rigidity assessment
topic Medical education training
simulation
neurological examination
spasticity
rigidity
muscle tone
url https://ieeexplore.ieee.org/document/10216320/
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AT christophermzallek modelingcontrolandclinicalvalidationofanupperlimbmedicaleducationtasktrainerforelbowspasticityandrigidityassessment
AT elizabeththsiaowecksler modelingcontrolandclinicalvalidationofanupperlimbmedicaleducationtasktrainerforelbowspasticityandrigidityassessment